274 AN EVALUATION OF CHILDREN SUSPECTED OF HAVING PULMONARY TUBERCULOSIS

Abstract

The aim of the study was to examine the diagnoses that are confused with pulmonary tuberculosis (TB) in children investigated and treated for tuberculosis. This prospective study was conducted in a region with a TB incidence of >800 new cases/100 000/year.Methods: Children suspected of having TB or pneumonia with peripheral eosincphilia (PIE) or congenital pulmonary anomalies were investigated.Results: Of the 340 children suspected of having TB (WHO criteria) 63 (19%) were found to have other pulmonary pathology [(pneumonia (35%), bronchopneumonia with wheezing (24%) or asthma with segmental/lobar collapse (14%)]. Of 14 children with PIE 6 (43%) were initially incorrectly diagnosed and treated for TB. Of 54 children with congenital lung anomalies 8 (15%) were treated for TB before the correct diagnosis was made. Congenital anomalies most often confused with TB were unilateral pulmonary hypoplasia, bronchogenic cyst and tracheal bronchus with anomalous lobe.Conclusion: In 19% of children initially thought to have TB another diagnosis was found. Pneumonia, bronchopneumonia with wheezing and asthma were the diagnosis most often confused with TB. Children with an atypical clinical picture or course should be examined for pneumonia with eosincphilia or congenital lung anomalies.